Dr. WHOA

Remember Dr. No? He’s the therapist I saw for a couple months in 2012 whose treatment protocols included running a magnet down my back. I’ve begun transcribing some of my old OCD journals, and yesterday, as I was going back through our session notes, I googled his name to see if he’d been up to anything lately.

As it turns out, he’s been up to quite a bit.

(Holy $&@^$%# *#&$!)

Just so we’re clear, Dr. No didn’t do anything inappropriate to me: I stopped seeing him because he didn’t know how to treat OCD. I knew it was the right decision at the time. I didn’t know just how right till yesterday.

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The Antidepressant Solution

And so we enter Week Three of Phase Three, and once again I don’t have much to report. The withdrawal symptoms have been mild: some obsessive thoughts, a lingering tiredness, but not much else. In his book entitled The Antidepressant Solution: A Step-by-Step Guide to Safely Overcoming Antidepressant Withdrawal, Dependence, and “Addiction” Joseph Glenmullen lists six criteria for determining if a person’s ready to start tapering off antidepressants. They are:

  1. The patient’s original condition has improved substantially.
  2. The patient is in a relatively stable, calm period in life.
  3. The patient has grown, or changed, psychologically in ways that make her less vulnerable to the condition the drug was used to treat.
  4. The patient’s life circumstances have changed so significantly that the circumstances originally making him depressed, anxious, or otherwise symptomatic are no longer present.
  5. The patient has significant side effects that contribute to the desire to go off the medication or that necessitate going off.
  6. The patient wants to go off the antidepressant rather than stay on it indefinitely because of concerns about long-term, largely unknown, side effects and risks, especially if she no longer needs the drug.

I meet at least five, if not all six of those criteria:

My OCD has improved substantially, especially since I went after my biggest fear and especially since making the conscious choice to stop caring so damn much about the disorder in the first place. (At the risk of belabouring the point, Dr. Steve Phillipson’s article about choice is an invaluable resource.)

I’m in as stable and calm a period in life as I have been in ages. I can’t stress this enough: my new, more relaxed travel schedule has had an incredibly positive effect on my mental health. Meanwhile, having Sam in the same house instead of being on opposite ends of the world’s second-biggest country has had a bigger impact than any antidepressant.

I’ve grown psychologically in ways that make me less vulnerable to the condition the drug was used to treat. Antidepressants certainly helped, but Exposure with Response Prevention – ERP – is what really got me where I am and what’ll keep me there long-term. By January, when the Great Trintellix Taper of 2018 started, antidepressants had become almost redundant: I didn’t need them to keep my anxiety in check because ERP was doing that already. And while antidepressants quiet my obsessive thoughts it’s at the expense of my vitality. I’m no longer willing to make that trade (and besides, ERP quiets them as well by rewiring the brain’s circuitry).

My life circumstances have changed so significantly that the circumstances originally making him symptomatic are no longer present. This one’s tougher to quantify since OCD’s a chronic condition. Again, though, moving back to Toronto and travelling far less frequently have had a sizeable impact.

I have significant side effects that contribute to the desire to go off the medication or that necessitate going off. Among other things, I’ve had a lot more energy since I started tapering – despite the current lethargy. And my mood’s been great.

I want to go off the antidepressant rather than stay on it indefinitely because of concerns about long-term, largely unknown, side effects and risks, especially if she no longer needs the drug. Firstly, and like I’ve said before, I feel as though anyone would rather take less medication if given the option (although I’m told that’s not the case – which baffles me, but there you go). Secondly, in general I’m worried about long-term side effects, yeah.

I guess that makes me six-for-six.

Roll on, June 20. And roll on to when I can start blogging about the Minnesota Vikings and Pearl Jam concerts (August 18 and 20 at Wrigley, baby!) and Hamilton instead of antidepressant withdrawal symptoms. I love having this platform for sharing my journey, but there’s a lot more I’d rather be writing about. We’ll be one step closer in six weeks.

Update

Phase Three of the Great Trintellix Taper of 2018 is nearing the end of its second week and…there still isn’t much to say, actually. Except this: two weeks ago I wrote, “I’m sure I’ll eventually have withdrawal symptoms to complain about, but based on previous experience I won’t start having them till the weekend.” I was wrong: I didn’t start having them till this past Saturday, eleven days after lowering my dosage from 10mg to 5. I can’t explain why. Maybe the drug’s efficacy’s wearing off. Or maybe all the spite riding’s turned me into a seratonin-producing machine.

Either way, we’ve got a new end date: Wednesday, June 20. I’m seeing The Phantom of the Opera that night to celebrate.

Phase Three

5mgIt’s hard finding much to say about the start of Phase Three of the Great Trintellix Taper of 2018 other than, “It’s started.” Today my dosage went down by 50%, from 10 mg to 5. I’m sure I’ll eventually have withdrawal symptoms to complain about, but based on previous experience I won’t start having them till the weekend. Inevitably my brain’s already scanning for issues, as though it understands it’s about to go through withdrawal again and it’s eager to get the party started. Poor guy: he’s been through a lot in 2018.

So we have a start date, April 25, and now, we have an end date: if all goes well I’ll be free of antidepressants on Wednesday, July 4. Stay tuned.

This Bites

An apple a day keep the doctor away, they say. Bullsh*t, I say! Because this afternoon an apple actually brought me to a doctor – or a dentist, rather. I explain!

I had an apple at 3pm. Also, I got braces 25-and-a-half years ago like pretty much everyone else I know. They were taken off in 1994; I’ve had a wire on my bottom teeth ever since. I’ve literally never had a problem with that wire; this is what the kids refer to as “foreshadowing.” I bit into the apple (as one does) and felt a piece of it stick inside the wire. I tried prodding it loose with my tongue and realized, hey, that’s a pretty hard piece of apple! Turns out it wasn’t a hard piece of apple but a hard piece of wire that’d broken loose and was now jabbing into the bottom of my tongue. Which is how I ended up at an emergency dentist’s office in Little Portugal having orthodontic work done for the first time in over two decades.

I don’t know what the takeaway here is, folks. I do know it was an unexpected way to end my last day in the office before April 24 – and that if anyone needs a great dentist in the west end of the city, drop me a line.

I Feel Good

Five weeks into Phase Two of the Trintellix Taper and I’ve got a major new development to report:

I feel good. Great, even.

And that’s it.

This is one of the most important things I’ve written on Stuff and Nonsense. I know I’m a cockeyed optimist, but I feel an obligation to be positive when writing about mental health, to let those who are still finding their footing know that things can, and will, get better. Positive mental health blogging may seem like a contradiction in terms, and goodness knows the interwebs are full of mental health blogs veritably drowning in negativity, but I promise to keep my writing upbeat as I solidify my gains.

My next appointment’s in three weeks.

Phase Two Weeks Later

I’ve been on 10mg of Trintellix for two full weeks. I still hope to finish tapering by early June, though that’ll partly depend on Ze Doctor: whereas I’m raring to go he’s much more restrained. And I need that restraint, because as much as I want to get this over with it’s far more important to do it properly. Yeah, it means the withdrawal symptoms are going to linger, but they’re nothing compared to what I experienced when I stopped taking antidepressants more-or-less cold turkey in 2014. As I wrote back then:

Day one was fine. Day two was okay. Day three was bad; day four was hellish. Day four was when the withdrawal symptoms really kicked in. Strangely enough I hadn’t really anticipated the possibility of negative side effects, yet they were myriad and surprisingly aggressive. I figured insomnia would be one of them, since one of my antidepressants was a sleeping aid, and it was. But what I didn’t reckon for was the nausea, dizziness, obsessive thoughts, or general sense of dread (not to mention some of the weirder side effects, like the inability to eat dairy or an itchy scalp). I think I was so focused on the end goal I never really stopped to consider the potential pitfalls. It took the better part of two weeks for the worst symptoms to abate.

I’ll take mild withdrawal symptoms over that any day.

(Not surprisingly the symptoms spiked during my recent work trip to Panama City, and in retrospect I probably should’ve waited till I was home before resuming the taper. My next trip, a ten-day jaunt to Dubai, Istanbul, and India, finishes on April 20; after that I’m home for good, one long weekend in Pittsburgh excepted.)

Those lingering side effects are abating. Meanwhile, the improved energy, motivation, and mental acuity remain, suggesting this taper’s establishing a new benchmark. I honestly feel as though I’ve begun uncovering the best version of me that’s ever existed (typical etc, but it’s true). It’s not just the taper that’s getting me there: it’s also the lifestyle changes, in particular a renewed commitment to proper diet. I can’t wait to see what the rest of 2018 brings. And I can’t wait to see how I’m feeling next week, when the new dosage should’ve fully kicked in.